急性心肌梗塞恢复期冠状动脉再通的探讨
韩立宪,张军,李洪稳,高巍,徐泽升,元柏民
摘要(Abstract)：
30例急性心肌梗塞(AMI)恢复期(2～4周),经冠状动脉造影(CAG)证实其梗塞相关冠状动脉(IRCA)处于完全闭塞及次全闭塞状态,全部行经皮冠状动脉腔内成形术(PTCA)及部分植入冠状动脉内支架(CASI).其冠状动脉再通29例,成功率96.7%,其中完全性再灌注27支(90%),部分再灌注2支(6.7%),仅1例IRCA 钢丝不能通过而失败.29例冠脉再通者随访2～36个月(平均18.7个月)无一例死亡,心功能均在Ⅰ～Ⅱ级.本文说明AMI恢复期冠状动脉再通是降低死亡率和维持正常心功能的一个有效方法.
关键词(KeyWords)： 急性心肌梗塞恢复期;经皮冠状动脉腔内成形术;冠状动脉内支架
基金项目(Foundation):
作者(Author): 韩立宪,张军,李洪稳,高巍,徐泽升,元柏民
参考文献(References)：
- [1]Topol EJ,Coronary angioplasty for acute myocardial infarction.Ann Intern Med,1988,109:970.
- [2]Eckman MH,Wong JB,Salem DN,et al.Direct angioplasty for acute myocardial infarction.Ann Intern Med,1992,117:667.
- [3]Topol EJ,Califf RM,George BS,et al.A randomized trial of immediate versus delayed elective angioplasty after intravenous tissue plasminogen activator in acute myocardial infarction.N Engl J Med,1987,317:581.
- [4]Califf RM,Topol EJ,George BS,et al.Charactertistics and outcome of patients in whom reperfusion with intravenous tissue type plasminogen activator fails:Results of the Thrombolysis and Angioplasty in Myocardial Infarction(TAMI)I trial.Circulation,1988,77:1090.
- [5]高润霖,姚康宝,陈纪林,等.急性心肌梗塞的经皮冠状动脉腔内成形术.中国循环杂志,1994,9:451.
- [6]李秀峰,沙燕石.在Q波型急性心梗后6周内采用PTCA治疗闭塞的梗塞区供血冠脉——对左室功能的影响.国外医学·心血管疾病分册,1995,2:115.